Traumatic spinal cord injury and neuromuscular diseases often result in severely impaired movement of the extremities. Impaired wrist, hand and finger movement are common with spinal cord injuries and neuromuscular diseases, especially traumatic spinal cord injury to the higher cervical spinal cord segments. Impaired coordination is a secondary problem often associated with these injuries. In addition to impaired movement of the extremities, spinal cord injuries and neuromuscular diseases often cause impaired bladder function. Not only may it be difficult to adequately empty the bladder, resulting in the need to routinely augment bladder drainage by intermittent self-catheterization with an internal catheter, but bladder control is also often compromised, resulting in unintentional discharge of urine. Elderly patients sometimes experience the same kinds of bladder control problems.
Various kinds of catheters have been used to solve the problems associated with incontinence caused by traumatic spinal cord injury, neuromuscular diseases, and advanced age. For example, there are generally three types of catheters used with male patients: External catheters (also known as condom catheters); indwelling internal catheters that are intended to remain inserted into the patient's bladder for extended periods; and intermittent internal catheters that are inserted only when catheterization is necessary.
The specific kind of catheter used at any given time varies, and depends to some extent upon the specific nature of the patient's requirements. For example, an external catheter is generally used on an ongoing basis when the patient's bladder has regained some degree of muscle control following a traumatic injury to the spinal cord. These devices fit externally over the penis, and usually have some kind of a sealing ring at the base of the penis. They are generally the most convenient and trouble free for use on an extended basis. However, external catheters can not always be used. For example, in the period immediately after a traumatic spinal cord injury the bladder is incapable of even spontaneous contraction which would cause urine to void. Since bladder contraction is a necessary requisite to use of an external catheter, use of these devices during the time period when the bladder does not function would be inappropriate. Furthermore, even when these devices may be used, there is still a need to utilize internal catheterization devices since there are times when an external catheter would be inconvenient or impossible to utilize. An external catheter is described by U.S. Pat. No. 4,588,397 to Giacalone.
An internal catheter is a small tubular device that is inserted into the urethra and extends up the urethra and into the bladder, thereby facilitating complete drainage of urine from the bladder. These devices may be used even when the bladder is incapable of spontaneous contraction. Indwelling internal catheters are generally used when the patient's bladder is incapable of even spontaneous contraction, such as the first few weeks immediately following a traumatic spinal cord injury. However, use of indwelling internal catheters over a long period of time is not possible because they are often associated with bacterial infections.
Due to the problems associated with indwelling internal catheters, patients are changed to intermittent internal catheterization as soon as their health is stabilized following a traumatic injury to the spinal cord. This eliminates the risk of infection associated with indwelling catheters. Intermittent internal catheterization is performed only when it is necessary to evacuate urine from the bladder (generally every four to six hours). Thus, these catheters may be used by patients who remain institutionalized and have not converted to use of external catheters. In addition, intermittent internal catheters may be utilized by those individuals who use external catheters to augment bladder drainage. For example, intermittant internal catheters may be used at those times when it would be inconvenient to use an external catheter, such as in the morning before showering, or at times when it would not be possible to empty the leg bag that is associated with an external catheter.
However, because patients suffering from traumatic spinal cord injury or various neuromuscular diseases have severely impaired movement of their hands and fingers, self-catheterization with either an internal intermittant or external catheter can be an extremely difficult or impossible procedure. As a result, many patients are unable to perform self-catheterization as a method of evacuating urine. This results in the procedure being performed by someone else, with the resultant deprivation of independence and privacy.
Thus, a need exists for a device that enables male patients suffering from injury or disease which causes incontinence and limited movement of the lower extremities, to perform self-catheterization. This is the primary objective of the present invention.